Aspergillus fumigatus colonization of punctal plugs
1Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh 11534, Saudi Arabia. k.tabbara@nesma.net.sa
Purpose:
Punctal plugs are used in patients with dry eye syndrome to preserve the tears. In this report, I present two cases of Aspergillus fumigatus colonization of punctal plugs.
Design:
Observational series of two cases.
Methods:
Approval was obtained from the institutional review board. Two men aged 29 and 31 years developed black spots inside the hole of punctal plug, which looked like eyeliner deposits. The deposits inside the hole of the plug in each patient were removed and cultured.
Results:
Cultures of the two punctal plugs black deposits grew A fumigatus. Bacterial cultures were negative.
Conclusions:
Colonization of the punctal plug hole with A fumigatus was observed in two cases. It is recommended that punctal plugs be removed in patients undergoing refractive or intraocular procedures or in patients who are receiving topical corticosteroids. Current punctal plugs should be redesigned to avoid the presence of an inserter hole.
Insights
Two patients experienced Aspergillus fumigatus colonization of their punctal plugs, leading to black deposits. This fungal growth highlights potential risks associated with punctal plugs in dry eye treatment.
Area of Science:
- Ophthalmology
- Medical Mycology
Background:
- Punctal plugs are commonly used to manage dry eye syndrome by conserving natural tears.
- Fungal colonization of medical devices can lead to sight-threatening infections.
Observation:
- Two male patients presented with black deposits resembling eyeliner within their punctal plug inserter holes.
- These deposits were cultured for microbial identification.
Findings:
- Cultures exclusively identified Aspergillus fumigatus in the black deposits from both patients' punctal plugs.
- Bacterial cultures were negative, indicating a specific fungal etiology.
Implications:
- Aspergillus fumigatus colonization of punctal plugs is a potential complication.
- Recommendations include punctal plug removal before ocular procedures and in patients on topical corticosteroids.
- Punctal plug design may require modification to prevent colonization.
